OT Practitioners’ Perception of Their Role in Care Coordination

PURPOSE: The purpose of this study was to explore the perceptions of pediatric occupational therapy practitioners regarding their role in care coordination activities. Studies have shown that 13% to 18% of children are considered to have special needs with prevalence anticipated to rise (Bethell, 2008). Fifteen to twenty-five percent of Children with Special Health Care Needs have unmet service needs (Porterfield & McBride, 2007). The American Academy of Pediatrics defines care coordination as “a process that links CSHCN and their families to services and resources to maximize the potential of children and provide them with optimal health care” (AAP, 1999, p. 978). They stated that while care coordination for children with medically complex needs is often assumed by nurses and social workers, occupational therapists can also lead or participate in these activities. If care coordination is an integral component of new healthcare delivery models, and if care coordination is within the scope of practice for OT practitioners, then it is important for pediatric OT practitioners to be aware of and engaged in care coordination activities. Therefore the research question for this study was “What are pediatric OT practitioners’ perceptions of their role in care coordination activities?”

DESIGN: This qualitative study used a phenomenological approach. Participant inclusion criteria included practicing, registered occupational therapy practitioners working in a pediatric setting. Occupational therapy practitioners were also required to understand and respond to questions verbally posed in English. Participants were not excluded based on their age, gender, sexual orientation, religion, or marital status. Recruitment utilizing purposeful, snowball sampling resulted in eleven pediatric practitioners indicating initial interest in participating. The ten consenting participants ranged in experience from 4 years to 38 years with an average of 18.5 years in practice. They were located in six different states in pediatric positions in outpatient, inpatient, school-based practice, private practice, and early intervention settings.

METHOD: An individual semi-structured, phone interview was conducted with each participant to regarding their perception of their role in care coordination activities. All interviews were digitally recorded and transcribed verbatim. Interviews were then coded and analyzed for recurring themes.

RESULTS: Five themes were identified including: belief that care coordination provides the best care for patients; communication is the most important aspect of care coordination; care coordination activities should be recognized with time acknowledged; the care coordinator role; and occupational therapy practitioners have the skills to coordinate care as well as being within their scope of practice. In the context of this study, the overarching themes expressed were that OT practitioners are participating in care coordination activities, these activities are within the scope of OT practice, and additional time and education are required for broader participation.

CONCLUSION: This study supported the research priority regarding the healthcare experience identified by the American Occupational Therapy Foundation in 2016. These study results provided several implications for OT practice such as the need for adapted productivity standards, opportunities for billing, and increased education regarding care coordination. Recommendations for future research include an expanded study using the same study question as well as studies focusing on effectiveness of OT practitioners in care coordination.

References

American Academy of Pediatrics, Council on Children with Disabilities (1999). Care Coordination: Integrating Health and Related Systems of care for children with special health care needs. Pediatrics, 104, 978-981. DOI: 10.1542/peds.2005-2070

Bethell, C., Read, D., Blumberg, S, & Newacheck, P. (2008). What is the prevalence of children with special health care needs? Maternal Child Health, 12(1), 1-14.

Porterfield, S., & McBride, T. (2007). The effect of poverty and caregiver education on perceived need and access to health services among children with special health care needs. American Journal of Public Health, 97(2), 323-329. DOI: 10.2105/AJPH.2004.055921